Rapid Detection of Antimicrobial Resistance Genes in Critically Ill Children Using a Custom TaqMan Array Card

Area of Science:

• Medical Microbiology
• Pediatric Critical Care
• Molecular Diagnostics

Background:

• Bacterial identification and antimicrobial susceptibility testing (AST) in critically ill children are slow.
• Antimicrobial resistance (AMR) poses a significant challenge in pediatric respiratory infections.
• Rapid diagnostics are needed to guide timely antimicrobial therapy.

Purpose of the Study:

• To validate a custom Antimicrobial Resistance gene TaqMan Array Card (AMR-TAC) for detecting AMR genes.
• To assess the feasibility of AMR-TAC as a screening tool in critically ill children.

Main Methods:

• Developed and validated a 23-target AMR-TAC using known resistant isolates.
• Applied AMR-TAC to lower respiratory tract and fecal samples from 82 mechanically ventilated children.
• Compared AMR-TAC results with phenotypic antimicrobial susceptibility testing.

Main Results:

• AMR genes were detected in 60% of children; multiple genes in 17%.
• Bacterial pathogens identified in 16% of children, with 31% exhibiting phenotypic AMR.
• Most AMR gene detections were not linked to identified phenotypic resistance.

Conclusions:

• AMR genes are frequently found in samples from mechanically ventilated children with suspected respiratory infections.
• AMR-TAC shows potential as an adjunct diagnostic for predicting antimicrobial treatment failure.
• Further research is needed to correlate gene detection with clinical outcomes.